Pilot Implementation of a Thermography-Driven Preventive Foot Care Protocol for Diabetes-Related Foot Ulcers in Community Health Centers: Non-Randomized Controlled Trial.

Abstract

AimThe purpose of this study was to clarify the effectiveness and implementation issues of a thermography-driven preventive foot care protocol for diabetes-related foot ulcers in Indonesian community health centers.MethodsIn the two trial centers examined between May 2023 and May 2024, one provided protocol-based care (Intervention group; n = 71), while the other provided standard education (Control group; n = 71). Participants were monitored for ulceration over a 1-year period.ResultsThere was no significant difference in the number of participants with ulceration between the intervention and control group (6 vs 8 cases, p = 0.573). However, there was a shorter time to ulceration (203.8 ± 8.7 vs 350.0 ± 13.9 days, p = 0.048) in the intervention group. Over the 1-year follow-up, protocol compliance was 100% for examinations, but 0% for callus and nail care. Participants without risk factors, such as neuropathy or angiopathy, also developed ulcers.ConclusionsResults suggested this protocol was ineffective in the community health center. It will be necessary to clarify the risk factors for foot ulcers in the target population, establish an appropriate protocol, prepare an environment for its implementation, and then conduct a randomized controlled trial in the future.